Evaluation of estimated creatinine clearance before steady state in acute kidney injury by creatinine kinetics.

Clinical and Experimental Nephrology
Masatomo YashiroTadashi Kamata

Abstract

A simple method to calculate estimated creatinine clearance using two serum creatinine concentration (Cr) values in acute kidney injury (AKI) was developed (eCrCl-AKI). We aimed to evaluate its accuracy and to clarify its contribution to the classification of AKI. We validated the errors in eCrCl-AKI in a simulation study after various reductions in creatinine clearance (CrCl) at various levels of chronic kidney disease (CKD). We compared the eCrCl-AKI-based classification of RIFLE criteria with the Cr-based classification or that proposed by Waikar and Bonventre. The regression equations of eCrCl-AKI on time were determined and Cr values were reconstructed by creatinine kinetics substituting CrCl with eCrCl-AKI in actual patients. Most errors in eCrCl-AKI were relatively small (from -13.6 to +7.9%) with the exception of two Cr values that straddled the changing trend of Cr. The classification according to RIFLE criteria based on Cr was unstable and did not enable adequate classification, especially in milder reductions of CrCl with advanced CKD. The classification based on eCrCl-AKI was stable and enabled adequate classification. There were good agreements between measured Cr and reconstructed Cr with eCrCl-AKI. The regression...Continue Reading

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Citations

Dec 25, 2015·Journal of Critical Care·Troy G SeelhammerMilo Engoren
Mar 31, 2015·PloS One·Fahim MohamedNicholas Buckley
May 25, 2013·Journal of the American Society of Nephrology : JASN·Sheldon Chen
Sep 17, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ryan L CrassManjunath P Pai
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Oct 13, 2017·British Journal of Clinical Pharmacology·Marlies OstermannUNKNOWN ADQI 16 workgroup
Feb 12, 2021·Clinical Pharmacology and Therapeutics·Cornelia B Landersdorfer, Roger L Nation
Mar 9, 2021·The Annals of Pharmacotherapy·David E Nix, Brian L Erstad
Mar 13, 2021·Critical Care Medicine·Maxime DesgrouasCharlotte Salmon Gandonnière

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